The performance improvements of the 3rd generation robot for the automated compounding of oncology drugs

Abstract

Background The collaboration established in 2007 between the Oncology Pharmacy of the University Hospital of Ancona and the Loccioni Group was aimed at implementing, validating and integrating the robotised system for the chemotherapic drugs compounding in the day-to-day pharmacy activity. Currently the Oncology Pharmacy is almost totally automated (95%) and Loccioni has its clinical site for the continuous engineering. During this 4-year period, the constant implementation gave rise to three generations of robot with the final version ApotecaChemo released late in 2009. The authors had the chance to experience all three generations and to validate the tough work done to increase efficiency, ergonomics and user-friendliness. Purpose The objective of this work is to analyse the performance of the third generation robot and to compare it with the previous ones.</p> Materials and methods Data were obtained from the robot database. An other advantage of automation is related to the data mining. Every step is measured and traced, providing a huge amount of information helpful for both performance statistics and process re-organisation. In this case, The authors compared production rate and the preparation time of specific drugs in standard protocols along the years.</p> Results The average preparation time of a fluorouracil bag of a CMF protocol halved from 303 to 156 s with the 3^rd generation robot. Similar trend is recorded for a methotrexate bag (CMF) and an epirubicin bag (FEC), whose preparation time passed from 276 to 127 s and from 565 to 253 s respectively. The improvement is even more significant for other drugs like gemcitabine, which is about 80%. Conclusions This technology has developed rapidly reaching high production rate. Nowadays, ApotecaChemo performances are comparable to those of the manual activity, with the added values of a quali-quantitative certification of each preparation compounded.

Comparing different robots available in the European market for the preparation of injectable chemotherapy and recommendations to users

“…Station ® (Omnicell) were not selected because the versions reported are no longer marketed in Europe. As previously reported by Batson et al, 13 Apoteca Chemo ® was the most comprehensively studied robot with 13 publications 3,[18][19][20][21][22][23][24][25][26][27][28][29] (5 additional publications since 2017). For four robots (Intelligent Compounding System ICS ® , Riva ® , Equashield Pro ® and Pharmoduct ® ), no publications were available.…”

“…Robots may differ in the types of compatible drug vials due to their size or their collar size (Table 3). With the Apoteca Chemo ® robot, Iwamoto et al 19 and Palma and Bufarini 23,24 reported using 56 and 160 different vials of 34 and 56 anticancer drugs, respectively. In the robots of the present study, a new drug could be added without the intervention of the manufacturer in the hospital.…”